Organization Active NPI

Taks Care Group LLC

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1831856442
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TAKS CARE GROUP LLC
Practice address
3830 Williamsburg Park Blvd Unit 4
Jacksonville, FL 32257-9200
Phone
(904) 217-8952
Fax
(682) 201-2130
NPI assigned
Nov 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christelle Takou Oben, APRNNPI 1821341801
Title
Ceo
Phone
(904) 907-7768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WW0000X
In Home Supportive Care Agency 253Z00000X
Health Service Clinic/Center 261QH0100X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3830 Williamsburg Park Blvd Unit 4
Jacksonville, FL 32257-9200

Mailing address

PO Box 600865
Jacksonville, FL 32260-0865
Phone (904) 217-8952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220915001173 FL Part B Supplier - Clinic/Group Practice 4789069527 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2298699Taks Care Group LLC3830 Williamsburg Park Unit 4, Jacksonville, FL 32257Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Locations

865 Blanding Blvd
Orange Park, FL 32065
Phone (904) 276-1133

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1831856442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600865",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322600865",
            "telephone_number": "904-217-8952",
            "fax_number": "682-201-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 WILLIAMSBURG PARK BLVD UNIT 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579200",
            "telephone_number": "904-217-8952",
            "fax_number": "682-201-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKS CARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "OBEN",
        "authorized_official_first_name": "CHRISTELLE",
        "authorized_official_middle_name": "TAKOU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-907-7768",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.